• J G Prévinaire, C J Mathias, W El Masri, J-M Soler, V Leclercq, and P Denys.
• Département médullaire, centre Calvé, fondation Hopale, 62600 Berck-sur-Mer, France. previnjg@hopale.com
• Ann Phys Rehabil Med. 2010 Oct 1;53(8):520-32.

ObjectivesTo present a comprehensive approach to the assessment of the severity of the autonomic lesion in spinal cord injury (SCI) patients, with regard to the level of lesion. To discuss how to assess an isolated sympathetic spinal cord that has lost supraspinal control (sympathetically complete lesion).MethodPubMed was searched for articles related to cardiovascular (mainly cold pressor test, respiratory and postural challenges) and sudomotor (sympathetic skin responses) tests that have been used. The results of these evaluations are analysed with regard to the site of stimulation (above or below the lesion) according to three types of SCI that offer typical autonomic reactions (tetraplegics, paraplegics at T6 and at T10).ResultsNon-invasive cardiovascular and sudomotor testing allows the assessment of the isolated sympathetic spinal cord in SCI patients. Typical responses are found in relation with the level of the sympathetic lesion. Its definition would allow comparison with the somatic motor and sensory level of lesion of SCI patients and provide additional aid to the classification of those patients.ConclusionFor research purposes on the integrity of the spinal sympathetic pathways, a battery of test approach is probably needed, using a combination of stimuli above and below the lesion, evaluating both cardiovascular and sudomotor pathways.Copyright © 2010 Elsevier Masson SAS. All rights reserved.

27 keywords...

hide…